| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,230 |
15,805 |
$1.27M |
| G9012 |
Other specified case management service not elsewhere classified |
2,910 |
2,598 |
$565K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,922 |
3,650 |
$278K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,178 |
2,858 |
$138K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,061 |
1,282 |
$132K |
| D0330 |
Panoramic radiographic image |
2,620 |
2,591 |
$97K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,729 |
687 |
$90K |
| 80305 |
|
7,822 |
3,479 |
$86K |
| D1110 |
Prophylaxis - adult |
2,610 |
2,575 |
$69K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,707 |
2,675 |
$47K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
1,694 |
1,226 |
$37K |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
4,792 |
1,914 |
$32K |
| D0140 |
Limited oral evaluation - problem focused |
1,818 |
1,779 |
$30K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
1,469 |
1,221 |
$28K |
| 90832 |
Psychotherapy, 30 minutes with patient |
440 |
285 |
$21K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
368 |
295 |
$20K |
| D0120 |
Periodic oral evaluation - established patient |
1,360 |
1,349 |
$17K |
| D0220 |
Intraoral - periapical first radiographic image |
1,908 |
1,852 |
$17K |
| D0274 |
Bitewings - four radiographic images |
973 |
963 |
$17K |
| D0210 |
Intraoral - complete series of radiographic images |
1,083 |
993 |
$16K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,043 |
952 |
$13K |
| D1206 |
Topical application of fluoride varnish |
852 |
840 |
$12K |
| 87428 |
|
404 |
376 |
$12K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
931 |
841 |
$12K |
| D1120 |
Prophylaxis - child |
295 |
294 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
214 |
201 |
$8K |
| 90837 |
Psychotherapy, 53 minutes with patient |
114 |
96 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
92 |
92 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
3,129 |
2,803 |
$7K |
| 99000 |
|
6,354 |
4,865 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,148 |
1,116 |
$7K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
195 |
139 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
677 |
672 |
$6K |
| 90791 |
Psychiatric diagnostic evaluation |
43 |
40 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
53 |
52 |
$4K |
| 87430 |
|
337 |
312 |
$4K |
| 99072 |
|
1,911 |
1,441 |
$4K |
| 92587 |
|
346 |
338 |
$4K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
28 |
24 |
$4K |
| 99177 |
|
681 |
671 |
$3K |
| 3078F |
|
1,744 |
1,603 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
56 |
55 |
$3K |
| 90686 |
|
211 |
208 |
$3K |
| 3074F |
|
2,429 |
2,198 |
$3K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
107 |
72 |
$2K |
| 90756 |
|
142 |
137 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
28 |
$2K |
| 92551 |
|
174 |
172 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
104 |
86 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
325 |
322 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 90656 |
|
76 |
71 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
135 |
128 |
$979.14 |
| 87807 |
|
70 |
65 |
$890.80 |
| 99443 |
|
16 |
15 |
$882.84 |
| 99442 |
|
15 |
14 |
$700.64 |
| 99174 |
|
173 |
168 |
$700.47 |
| D9995 |
|
12 |
12 |
$420.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
47 |
25 |
$290.68 |
| 0001A |
|
16 |
16 |
$220.22 |
| 87400 |
|
15 |
15 |
$65.52 |
| 3079F |
|
740 |
659 |
$50.00 |
| 90785 |
|
98 |
59 |
$36.00 |
| 99173 |
|
14 |
14 |
$32.11 |
| 36416 |
|
106 |
103 |
$3.03 |
| 3077F |
|
86 |
79 |
$0.00 |
| 3075F |
|
71 |
63 |
$0.00 |